Most Relevant Information
Provider Data
| NPI Number: | 1003442476 |
| Provider Name: | MICHAELLA ELIZABETH MARZULLO |
| Entity Type: | Individual |
| Taxonomy Code: | 363A00000X |
| Specialty: | Physician Assistant |
| License Number: |
Most Important Dates
| Enumeration Date: | 03/18/2020 |
| Last Updated: | 03/18/2020 |
Provider Practice Location
100 KENYON AVE
WAKEFIELD
RI
028794299
Practice Location Phone/Fax
| Phone: | 4017828000 |
| Fax: |
Provider Mailing Location
20 POND HOLLOW RD
NORTH KINGSTOWN
RI
028525941
Provider Mailing Phone/Fax
| Phone: | 4015759940 |
| Fax: |